Levonorgestrel (lee-voe-nor-JES-trel)

Prevents pregnancy for up to 5 years. This implant slowly releases levonorgestrel, a hormone.

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Implant

• This medicine is a set of 2 hormone-releasing birth control implants that is surgically placed and removed under the skin of the upper arm by a trained healthcare provider. The implants are placed in the upper arm for up to 5 years.
• The implants are usually inserted by your doctor within the first 7 days of your regular menstrual period. Your doctor also needs to do a pregnancy test before inserting the implants.
• After the implants are inserted, your doctor should feel your arm to check that the implants are in the right place. If you cannot feel the implants in your arm, you will need to use a non-hormonal birth control (such as condoms, spermicide) until your doctor confirms that the implants are in place.
• Your doctor will cover the insertion site with a gauze bandage. Keep it dry and avoid heavy lifting for 2 to 3 days. The gauze may be removed after 1 to 3 days.
• Do not try to remove the implants by yourself.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how this device works. Tell your doctor if you are using any of the following:
  • Aprepitant, bosentan, carbamazepine, cyclosporine, felbamate, fluconazole, griseofulvin, itraconazole, ketoconazole, lamotrigine, oxcarbazepine, phenobarbital, phenytoin, rifabutin, rifampicin, rufinamide, St John's wort, topiramate, or voriconazole
  • Birth control pill
  • Medicine to treat HIV infection
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease (including tumor), blood clotting problems, breast cancer, diabetes, migraine headaches, heart disease, stroke, heart attack, high blood pressure, or a history of depression. Tell your doctor if you have problems with your immune system or have had surgery on your female organs (especially fallopian tubes).
• This medicine may cause the following problems:
  • Increased risk of ectopic pregnancy (pregnancy outside the uterus)
  • Increased risk for ovarian cysts
• You could have less bleeding or even stop having periods by the end of the first year. Call your doctor if you have a change from the regular bleeding pattern after you have had your implants for awhile, such as more bleeding or if you miss a period (and you were having periods even with your implants).
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, problems with speech or walking, numbness or weakness in your arm or leg or on one side of your body
• Severe headache, vision changes
• Stomach or pelvic pain, tenderness, or cramping that is sudden or severe
• Yellow skin or eyes

If you notice these less serious side effects, talk with your doctor:

• Acne or other skin changes
• Breast pain
• Change in bleeding pattern after the first few months
• Hair loss
• Headache
• Pain at the insertion site
• Weight gain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088